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Periodontal Risk Assessment Questionnaire Name Date Tobacco Use is the most significant risk factor for gum disease. Do you now or have you ever used the following: Cigarette Cigar Pipe ChewingAmounts
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How to fill out tobacco use family history

How to fill out tobacco use family history
01
Start by gathering information about your immediate family members (parents, siblings) and extended family members (grandparents, aunts, uncles, cousins) who have a history of tobacco use.
02
Contact your family members and ask them about their tobacco use history. Record information about their smoking or chewing tobacco habits, including how often they smoked or chewed, how many years they used tobacco, and whether they have quit or still continue to use tobacco.
03
Document any health problems or diseases that are associated with tobacco use in your family members. This may include lung cancer, heart disease, stroke, or other tobacco-related illnesses.
04
Keep the information organized and easily accessible for future reference. You can create a family tree or use a spreadsheet to record the details of each family member's tobacco use history.
05
Share this information with your healthcare provider during your medical appointments. Your tobacco use family history can help identify any potential risks or genetic predispositions to tobacco-related diseases and guide personalized healthcare recommendations.
Who needs tobacco use family history?
01
Anyone who wants to understand their potential risks or genetic predispositions to tobacco-related diseases can benefit from having a tobacco use family history.
02
It is particularly important for individuals who are considering using tobacco products or those who are already using tobacco to understand their family history as it can provide valuable insights into the potential health consequences.
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What is tobacco use family history?
Tobacco use family history refers to documenting information about the use of tobacco products by family members, such as parents, siblings, and grandparents.
Who is required to file tobacco use family history?
Individuals who are applying for certain jobs, insurance policies, or medical procedures may be required to file tobacco use family history.
How to fill out tobacco use family history?
To fill out tobacco use family history, individuals must provide details about the tobacco use habits of their family members, including frequency, duration, and current status.
What is the purpose of tobacco use family history?
The purpose of tobacco use family history is to assess potential health risks associated with tobacco use that may be hereditary or influenced by family members.
What information must be reported on tobacco use family history?
Information that must be reported on tobacco use family history includes the type of tobacco products used, duration of use, frequency of use, and any related health issues.
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